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Rigshospitalet - a part of Copenhagen University Hospital
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Role of the lymphatic vasculature in cardiovascular medicine

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  1. Valve regurgitation in patients surviving endocarditis and the subsequent risk of heart failure

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  2. Alcohol septal ablation in patients with severe septal hypertrophy

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  3. Interaction of ischaemic postconditioning and thrombectomy in patients with ST-elevation myocardial infarction

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  4. Outcome after heart-lung or lung transplantation in patients with Eisenmenger syndrome

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  5. Significantly increased risk of all-cause mortality among cardiac patients feeling lonely

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  1. Functional Capacity Past Age 40 in Patients With Congenital Ventricular Septal Defects

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  2. Diagnosis and Management of Lymphatic Disorders in Congenital Heart Disease

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  3. Congenital Heart Disease and Risk of Suicide and Self-Harm: A Danish Nationwide Cohort Study

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The lymphatic vasculature has traditionally been considered important for removal of excessive fluid from the interstitial space, absorption of fat from the intestine and the immune system. Advances in molecular medicine and imaging have provided us with new tools to study the lymphatics. This has revealed that the vessels are actively involved in regulation of immune cell trafficking and inflammation. We now know much about how new lymphatic vessels are created (lymphangiogenesis) and that this is important in, for example, wound healing and tissue repair. The best characterised pathway for lymphangiogenesis is the vascular endothelial growth factor C (VEGF-C)/VEGFR3 pathway. Over recent years, there has been an increasing interest in the role of the lymphatics in cardiovascular medicine. Preclinical studies have shown that lymphangiogenesis and immune cell trafficking play a role in cardiovascular conditions such as atherosclerosis, recovery after myocardial infarction and rejection of cardiac allografts. Targeting the VEGF-C/VEGFR3 pathway can be beneficial in these conditions. The clinical spectrum of lymphatic abnormalities and lymphoedema is wide and overlaps with congenital heart disease. Important long-term complications to the Fontan circulation involves the lymphatics. New and improved imaging modalities has improved our understanding and management of these patients. Lymphatic leaks and flow abnormalities can be successfully treated, minimally invasively, with percutaneous embolisation. Future research will prove if the preclinical findings that point to a role of the lymphatics in several cardiovascular conditions will result in new treatment options.

Original languageEnglish
JournalHeart (British Cardiac Society)
Volume105
Issue number23
Pages (from-to)1777-1784
ISSN1355-6037
DOIs
Publication statusPublished - Dec 2019

ID: 59300641